Researchers Propose Standardized Dysphotopsia Reporting

Dysphotopsias can get in the way of many daily activities, such as driving, reading and using electronics, and may also cause headaches, eyestrain and difficulty adjusting to low-light settings. Though most resolve on their own after about a year, many patients experience persistent, problematic symptoms. Photo: Huang RS, Verhoeff N, Balas M, et al. Ophthalmology Glaucoma 2026. Click image to enlarge. Along with refractive surprises, dysphotopsias are a major cause for patient dissatisfaction after cataract surgery. These visual symptoms can have a profound effect on patients’ visual function and quality of life and may manifest in a number of forms, frequencies and severities. Given their variability and potential impact on patient satisfaction, understanding dysphotopsias is essential; however, there are widespread inconsistencies in how they’re reported. In an effort to standardize the assessment of visual side effects, a multinational group of researchers developed a consensus-based classification system and questionnaire for reporting dysphotopsias after procedures.To create this system, researchers first performed a literature search to identify randomized controlled trials and observational studies reporting post-procedure dysphotopsias (n=5,059). Of these studies, 142 met inclusion criteria, and the researchers extracted 34 unique dysphotopsias symptoms and 76 questionnaire items.Using the iterative Delphi consensus process, a panel of 20 subspecialists (glaucoma, cataract/refractive and cornea) evaluated each item for inclusion, exclusion or rewording; they could also propose additional items. Consensus was defined a priori as ≥80% agreement. Items were progressively refined until at least 80% of all proposed items achieved consensus. You can download the DYSQO patient questionnaire here. The final classification system included 11 baseline clinical variables, seven positive dysphotopsias symptoms (halos, glare/dazzle, starbursts, arcs, lines/streaks, ghosting and flickering/shimmering), one negative dysphotopsias symptom (peripheral crescent/shadow), five environmental modifiers, two quality-of-life and mental health items, and eight attempted interventions. These items were used to create the DYsphotopsia Symptom Questionnaire and Outcomes (DYSQO) for clinical and research use.The DYSQO questionnaire is made up of five sections:1. Baseline Information. This section includes clinical variables such as demographics, procedure/diagnosis, IOL type, presence of iridotomy, iris color and mental health diagnoses.2. Visual Symptoms. This section lists positive and negative dysphotopsias and asks the patient to indicate the presence or absence, severity and frequency of each.3. Environmental Triggers. This section encompasses different light exposure situations, including bright sunlight, low light, artificial lighting, transitional lighting conditions and screen use.4. Quality of Life and Mental Health. This section covers the degree that visual disturbances affect daily life and asks how often these symptoms induce feelings of anxiety or depression.5. Interventions. This section lists interventions such as optical aids, ocular surface management, procedural intervention, miotics and mydriatics, laser and refractive surgery, and asks the patient to report whether or not they’ve attempted the intervention and its effectiveness.The research group believes that “adoption of this tool in research and clinical practice may enhance the consistency, clarity and quality of dysphotopsias reporting, enabling comparisons across interventions and enhancing evidence-based patient care.”Click here for the journal source. Huang RS, Verhoeff N, Balas M, et al. Standardized classification system for dysphotopsias reporting. Ophthalmology Glaucoma 2026. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.